Chapter 8

The Skeletal System:

The Appendicular Skeleton

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Skeleton of the Upper Limb

 Each upper limb has 32 bones

 Two separate regions
 1. The pectoral (shoulder) girdle (2 bones)
 2. The free part (30 bones)

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The Pectoral (or Shoulder) Girdle
Figure 8.1

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Upper Limb

 The pectoral girdle consists of two bones, the

scapula and the clavicle
 The free part has 30 bones
 1 humerus (arm)
 1 ulna (forearm)
 1 radius (forearm)
 8 carpals (wrist)
 19 metacarpal and phalanges (hand)

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Pectoral Girdle - Clavicle

 The clavicle is “S” shaped

 The medial end articulates with the
manubrium of the sternum forming the
sternoclavicular joint
 The lateral end articulates with the acromion
forming the acromioclavicular joint

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The Clavicle
Figure 8.2 Copyright 2009 John Wiley & Sons, Inc.
Pectoral Girdle - Clavicle

 The clavicle is convex in shape anteriorly near the

sternal junction
 The clavicle is concave anteriorly on its lateral edge
near the acromion

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Clinical Connection - Fractured
Clavicle
 A fall on an outstretched arm (F.O.O.S.H.)
injury can lead to a fractured clavicle
 The clavicle is weakest at the junction of the
two curves
 Forces are generated through the upper limb
to the trunk during a fall
 Therefore, most breaks occur approximately
in the middle of the clavicle

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Pectoral Girdle - Scapula

 Also called the shoulder blade

 Triangular in shape
 Most notable features include the spine,
acromion, coracoid process and the glenoid
cavity

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Features on the Scapula

 Spine - a large process on the posterior of

the scapula that ends laterally as the
acromion
 Acromion - the flattened lateral portion of the
spine of the scapula
 Coracoid process - a protruding projection on
the anterior surface just inferior to the lateral
aspect of the clavicle
 Glenoid cavity - shallow concavity that
articulates with the head of the humerus
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Scapula
Figure 8.3
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Scapula
Figure 8.3
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Scapula - Features

 The medial (vertebral) border - closest to the

vertebral spine
 Lateral border - closest to the arm
 Superior border - superior edge
 Inferior angle - where medial and lateral
borders meet inferiorly
 Superior angle - uppermost aspect of scapula
where medial border meets superior border

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Scapula - Features

 Subscapular fossa - anterior concavity where

the subscapularis muscle attaches
 Supraspinous fossa - posterior concavity
superior to the scapular spine, attachment
site for supraspinatus muscle
 Infraspinous fossa - posterior concavity
inferior to the scapular spine, site of
infraspinatus muscle

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Skeleton of the Arm - Humerus

 Longest and largest bone of the free part of

the upper limb
 The proximal ball-shaped end articulates with
the glenoid cavity of the scapula
 The distal end articulates at the elbow with
the radius and ulna

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Humerus - Surface Features

 The head of the humerus has two unequal-

sized projections
 The greater tubercle lies more laterally
 The lesser tubercle lies more anteriorly
 Between the tubercles lies the intertubercular
groove or sulcus (bicipital groove) where the
long head of the biceps brachii tendon is
located

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Humerus - Surface Features

 Just distal to the head is the anatomical neck

 The surgical neck is where the tubular shaft begins
and is a common area of fracture
 About mid-shaft on the lateral aspect is a roughened
area, the deltoid tuberosity where the deltoid tendon
attaches
 Capitulum - a round knob-like process on the lateral
distal humerus
 Trochlea - medial to the capitulum, is a spool-
shaped projection on the distal humerus

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Humerus - Surface Features

 Coronoid fossa - anterior depression that

receives the coronoid process of the ulna
during forearm flexion
 Olecranon fossa - posterior depression that
receives the olecranon of the ulna during
forearm extension
 The medial and lateral epicondyles are bony
projections to which the forearm muscles
attach
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Humerus and
Glenohumeral
Joint
Figure 8.4

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Skeleton of the Forearm - Ulna

 The longer of the two forearm bones

 Located medial to the radius
 Olecranon - the large, prominent proximal end, the
“tip of your elbow”
 Coronoid process - the anterior “lip” of the proximal
ulna
 Trochlear notch - the deep fossa that receives the
trochlea of the humerus during elbow flexion
 Styloid process - the thin cylindrical projection on the
posterior side of the ulna’s head

Copyright 2009 John Wiley & Sons, Inc.

Copyright 2009 John Wiley & Sons, Inc.
Right
humerus in
relation to
scapula,
ulna, and
radius--
Figure 8.5

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Articulations
formed by the
ulna and radius
-- Figure 8.7

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Radius

 Lies lateral to the ulna (thumb side of the forearm)

 The head (disc-shaped) and neck are at the
proximal end
 The head articulates with the capitulum of the
humerus and the radial notch of the ulna
 Radial tuberosity - medial and inferior to neck,
attachment site for biceps brachii muscle
 Styloid process - large distal projection on lateral
side of radius

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Ulna and Radius

 The shaft of these bones are connected by

an interosseus membrane
 There is a proximal radioulnar joint and a
distal radioulnar joint
 Proximally, the head of the radius articulates
with the radial notch of the ulna
 Distally, the head of the ulna articulates with
the ulnar notch of the radius

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 Right ulna
and radius
in relation
to the
humerus
and
carpals --
Figure 8.6

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Skeleton of the Hand

 The carpus (wrist) consists of 8 small bones

(carpals)
 Two rows of carpal bones
 Proximal row - scaphoid, lunate, triquetrum, pisiform
 Distal row - trapezium, trapezoid, capitate, hamate
 Scaphoid - most commonly fractured
 Carpal tunnel - space between carpal bones and
flexor retinaculum

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Articulations
formed by the
ulna and radius
-- Figure 8.7

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Metacarpals and Phalanges

 Five metacarpals - numbered I-V, lateral to

medial
 14 phalanges - two in the thumb (pollex) and
three in each of the other fingers
 Each phalanx has a base, shaft, and head
 Joints - carpometacarpal,
metacarpophalangeal, interphalangeal

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Right wrist
and hand in
relation to
ulna and
radius --
Figure 8.8

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Skeleton of the Lower Limb

 Skeleton of the Lower Limb

 Two separate regions
 1. A single pelvic girdle (2 bones)
 2. The free part (30 bones)

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Pelvic (Hip) Girdle

 Each coxal (hip) bone consists of three bones

that fuse together: ilium, pubis, and ischium
 The two coxal bones are joined anteriorly by
the pubic symphysis (fibrocartilage)
 Joined posteriorly by the sacrum forming the
sacroiliac joints (Fig 8.9)

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Right Hip Bone
Figure 8.10

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Bony
Pelvis
Figure
8.9
The Ilium

 Largest of the three hip bones

 Ilium is the superior part of the hip bone
 Consists of a superior ala and inferior body which
forms the acetabulum (the socket for the head of the
femur)
 Superior border - iliac crest
 Hip pointer - occurs at anterior superior iliac spine
 Greater sciatic notch - allows passage of sciatic
nerve

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Ischium and Pubis

 Ischium - inferior and posterior part of the hip

bone
 Most prominent feature is the ischial
tuberosity, it is the part that meets the chair
when you are sitting
 Pubis - inferior and anterior part of the hip
bone

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False and True Pelves

 Pelvic brim - a line from the sacral promontory

to the upper part of the pubic symphysis
 False pelvis - lies above this line (Fig 8.9b)
 Contains no pelvic organs except urinary
bladder (when full) and uterus during pregnancy
 True pelvis - the bony pelvis inferior to the pelvic
brim, has an inlet, an outlet and a cavity
 Pelvic axis - path of baby during birth

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True and False Pelvis Figure 8.11

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Comparing Male and Female Pelves

 Males - bone are larger and heavier

 Pelvic inlet is smaller and heart shaped
 Pubic arch is less the 90°
 Female - wider and shallower
 Pubic arch is greater than 90°
 More space in the true pelvis (Table 8.1)

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Comparing Male and Female Pelves
Table 8.1 Copyright 2009 John Wiley & Sons, Inc.
Comparing Male and Female Pelves
Table 8.1
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Right Lower Limb
Figure 8.12

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 Skeleton of the Thigh - Femur and Patella
 Femur - longest, heaviest, and strongest bone in the
body
 Proximally, the head articulates with the acetabulum
of the hip bone forming the hip (coxal) joint
 Neck - distal to head, common site of fracture
 Distally, the medial and lateral condyles articulate
with the condyles of the tibia forming the knee joint
 Also articulates with patella

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Femur

 Greater and lesser trochanters are projections

where large muscles attach
 Gluteal tuberosity and linea aspera - attachment
sites for the large hip muscles
 Intercondylar fossa - depression between the
condyles
 Medial and lateral epicondyles - muscle site
attachments for the knee muscles

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Right
Femur
Figure
8.13

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Patella
 Largest sesamoid bone in the body
 Forms the patellofemoral joint
 Superior surface is the base
 Inferior, narrower surface is the apex
 Thick articular cartilage lines the posterior
surface
 Increases the leverage of the quadriceps
femoris muscle
 Patellofemoral stress syndrome - “runner’s
knee”

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Patella Figure 8.14

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Tibia (shin bone)

 The larger, medial weight-bearing bone of the

leg
 The lateral and medial condyles at the
proximal end articulate with the femur
 It articulates distally with the talus and fibula
 Tibial tuberosity - attachment site for the
patellar ligament
 Medial malleolus - medial surface of distal
end (medial surface of ankle joint)

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Fibula

 The smaller, laterally placed bone of the leg

 Non-weight bearing
 The head forms the proximal tibiofibular joint
 Lateral malleolus - distal end, articulates with
the tibia and the talus at the ankle

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Tibia
and
Fibula
Figure
8.15

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Tibia and Fibula Figure 8.15

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Skeleton of the Foot - Tarsals,
Metatarsals, and Phalanges
 Seven tarsal bones - talus (articulates with
tibia and fibula), calcaneus (the heel bone,
the largest and strongest), navicular, cuboid
and three cuneiforms
 Five metatarsals - (I-V) base, shaft, head
 14 phalanges (big toe is the hallux)
 Tarsus = ankle

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Right
Foot
Figure
8.16

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Arches of the Foot

 Two arches support the weight of the body

 Provide spring and leverage to the foot when
walking
 The arches flex when body weight applied
 Flatfoot - the arches decrease or “fall”
 Clawfoot - too much arch occurs due to various
pathologies

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Arches of the foot - Figure 8.17

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